Causes of dysphasia

Case contributed by Dr Craig Hacking

Presentation

One year history of sensation of foreign body in throat. Exclude malignancy.

Patient Data

Age: 78
Gender: Female
Modality: CT

No foreign body evident.

There is no lymph node enlargement or mass identified. The inferior 2.5cm of the right stylohyoid ligament is calcified.

The vascular enhancement is normal. No mucosal lesion is seen.

Although the origin of the right subclavian artery is not included in the images, is not arising from the brachiocephalic trunk and therefore represents a retroesophageal aberrant right subclavian artery. The brachiocephalic trunk appears to originate from a single aortic arch vessel, shared with the left common carotid artery (bovine arch).

The thyroid and salivary glands are normal.

The lung apices are clear. No suspicious bone lesion identified.

Conclusion

  • No mass lesion or FB.
  • There are two possible causes of the patient's symptoms which could be differentiated with a barium swallow study:
    • Retroesophageal aberrant right subclavian artery - dysphasia lusoria.
    • Calcification of the inferior right stylohyoid ligament - Eagle syndrome.

Case Discussion

The patient was lost to follow up.

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Case Information

rID: 40149
Case created: 9th Oct 2015
Last edited: 12th Oct 2015
Inclusion in quiz mode: Included

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